Sickness Prevention Achieved through Regional Collaboration (SPARC), Newton, MA 02465, USA.
Am J Public Health. 2012 Aug;102(8):e44-50. doi: 10.2105/AJPH.2012.300701. Epub 2012 Jun 14.
To determine the optimum strategy for increasing up-to-date (UTD) levels in older Americans, while reducing disparities between White, Black, and Hispanic adults, aged 65 years and older.
Data were analyzed from the 2008 Behavioral Risk Factor Surveillance System, quantifying the proportion of older Americans UTD with influenza and pneumococcal vaccinations, mammograms, Papanicolaou tests, and colorectal cancer screening. A comparison of projected changes in UTD levels and disparities was ascertained by numerically accounting for UTD adults lacking 1 or more clinical preventive services (CPS). Analyses were performed by gender and race/ethnicity.
Expanded provision of specific vaccinations and screenings each increased UTD levels. When those needing only vaccinations were immunized, there was a projected decrease in racial/ethnic disparities in UTD levels (2.3%-12.2%). When those needing only colorectal cancer screening, mammography, or Papanicolaou test were screened, there was an increase in UTD disparities (1.6%-4.5%).
A primary care and public health focus on adult immunizations, in addition to other CPS, offers an effective strategy to reduce disparities while improving UTD levels.
确定提高美国老年人最新（Up-to-date，UTD）接种率的最佳策略，同时减少白人、黑人和西班牙裔成年人之间的差异，年龄在 65 岁及以上。
分析了来自 2008 年行为风险因素监测系统的数据，量化了老年人中流感和肺炎球菌疫苗、乳房 X 光检查、巴氏涂片检查和结直肠癌筛查的 UTD 比例。通过数值计算缺乏 1 种或多种临床预防服务（Clinical Preventive Services，CPS）的 UTD 成年人，比较了 UTD 水平和差异的预计变化。分析按性别和种族/族裔进行。
扩大特定疫苗和筛查的提供均提高了 UTD 水平。当仅需要接种疫苗的人接种疫苗时，UTD 水平的种族/族裔差异预计会减少（2.3%-12.2%）。当仅需要结直肠癌筛查、乳房 X 光检查或巴氏涂片检查的人接受筛查时，UTD 差异会增加（1.6%-4.5%）。
初级保健和公共卫生重点关注成人免疫接种以及其他 CPS，是在提高 UTD 水平的同时减少差异的有效策略。
